IMPORTANCE OF HUMAN IMMUNODEFICIENCY VIRUS-ASSOCIATED LYMPHADENOPATHYAND TUBERCULOUS LYMPHADENITIS IN PATIENTS UNDERGOING LYMPH-NODE BIOPSY IN ZAMBIA

The relative importance of human immunodeficiency virus (HIV)-associat ed lymphadenopathy amongst patients presenting for lymph node biopsy i n Central Africa is unknown. HIV-1 serology and histology of patients undergoing superficial lymph node biopsy during 1989-1990 in Lusaka, Z ambia, were examined in a prospective cohort study of HIV serology and by retrospective review of laboratory records. Of 727 lymph nodes bio psied in Lusaka in 1989-1990, 380 (52 per cent) showed tuberculous lym phadenitis, 160 (22 per cent) histology suggestive of primary HIV lymp hadenopathy and 66 (9 per cent) nodal Kaposi's disease. HIV serology w as tested in 280 adults and was positive in 91 per (255 patients), inc luding 89 per cent (153 of 171) of those with tuberculous lymphadeniti s, 98 per cent (63 of 64) of those with histology suspicious of primar y HIV lymphadenopathy and all (24 of 24) with nodal Kaposi's disease. Other HIV-associated lymphadenopathy included nodal lymphomas and lymp hoepithelial cysts. HIV serology was tested in 22 children and was pos itive in eight, including four of 14 with tuberculous lymphadenitis. I t is concluded that HIV-associated lymphadenopathy, especially tubercu lous lymphadenitis, is very common amongst patients presenting for lym ph node biopsy in Central Africa.